Related Experiment Video
Updated: Dec 20, 2025
A Simple High Efficiency Protocol for Pancreatic Islet Isolation from Mice
Published on: August 30, 2019
Effectivity of Pancreatic Enzyme Replacement Therapy in Malnourished Children
Burcu Güven1, Mevsim Demir Mis2, Kamuran Karaman3
1Department of Pediatric Gastroenterology, Karadeniz Technical University Faculty of Medicine, Trabzon.
Insights
Pancreatic enzyme replacement therapy (PERT) did not significantly improve weight gain or exocrine pancreatic insufficiency (EPI) markers in malnourished children over 8 weeks. Further research is needed for effective malnutrition treatments in children without chronic diseases.
Area of Science:
- Pediatric Nutrition
- Gastroenterology
- Endocrinology
Background:
- Malnutrition is prevalent in children with exocrine pancreatic insufficiency (EPI).
- Pancreatic enzyme replacement therapy (PERT) is standard for acute malnutrition in children with EPI-associated diseases.
- The efficacy of PERT for malnutrition without chronic disease is not well-established.
Purpose of the Study:
- To evaluate the effectiveness of PERT on weight gain and EPI in moderately and severely malnourished children.
- To compare outcomes between children receiving PERT plus supplements and those receiving supplements alone.
Main Methods:
- A randomized controlled trial involving 40 children (aged 2-16) classified as moderately or severely malnourished.
- Group 1 received PERT (2000 U lipase/kg/day) with hypercaloric enteral supplements.
- Group 2 received hypercaloric enteral supplements only. Measurements included anthropometrics and fecal elastase-1 (FE-1) at baseline and 8 weeks.
Main Results:
- All participants had EPI, with 60% exhibiting severe EPI.
- Both groups showed significant improvements in weight, height, and BMI.
- No significant differences were observed between the PERT and control groups in anthropometric measures or FE-1 levels.
Conclusions:
- PERT did not demonstrate a significant benefit over nutritional supplements alone in improving weight gain or EPI markers in malnourished children.
- Malnutrition remains a critical public health issue requiring novel treatment strategies.
- Further investigation into PERT's role in specific pediatric malnutrition contexts is warranted.
Objective:
Malnutrition is commonly seen in children with exocrine pancreatic insufficiency (EPI). Pancreatic enzyme replacement therapy (PERT) is the mainstay treatment of acute malnutrition in children detected with a disease closely associated with EPI (eg, cystic fibrosis). The effectiveness of PERT in children with malnutrition without any chronic disease, however, remains unclear. The aim of this study was to investigate the effectiveness of PERT on weight gain and EPI in children classified as moderately and severely malnourished according to the World Health Organization (WHO) classification.
Materials And Methods:
The study included a total of 40 children aged 2-16 years who were classified as moderately and severely malnourished according to the WHO classification. The patients were randomly divided into 2 groups: PERT group (n = 20) received 2000 U lipase/kg/day (in 4 doses) in addition to hypercaloric enteral supplements and control group received hypercaloric enteral supplements only. In both groups, anthropometric measurements and the assessment of fecal elastase-1 (FE-1) levels were performed both at first admission and at the end of the 8-week treatment period.
Results:
On the basis of WHO classification, 10 (25%) children were classified as severely malnourished and 30 (75%) children as moderately malnourished. EPI was detected in all the patients, among whom 24 (60%) patients had severe EPI. At the end of the treatment, body weight, height, and body mass index (BMI) increased significantly in both groups compared to their pre-treatment values, whereas no significant difference was found with regard to waist circumference (WC) and FE-1 levels. Similarly, no significant difference was found between pre- and posttreatment measurements of PERT and control groups (P > 0.05) and between pre- and posttreatment measurements of patients with moderate and severe malnutrition (P > 0.05).
Conclusions:
Malnutrition remains a serious public health problem, and thus, the development of novel treatment methods is highly essential. PERT is one of the most commonly considered alternatives, although there is little documentation of PERT in the literature. In the present study, although PERT resulted in higher weight gain, it established no significant difference between the 2 groups.
Related Concept Videos
01:29Chronic Pancreatitis II: Collaborative Care
Assessment:
01:21Overview of Protein Metabolism
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
01:26Pancreatic Juice and Secretion
When acidic chyme from the stomach enters the duodenum, it triggers the release of secretin, a hormone that prompts pancreatic juice secretion. After a fatty meal, cholecystokinin, another hormone, stimulates gallbladder contraction and enhances enzyme-rich...